title: [Transoral CO2 laser epiglottectomy for early epiglottic carcinomas].
abstract: OBJECTIVE
  To compare the functional results of transoral CO2 laser epiglottectomy with transcervical supraglottic laryngectomy and to find the landmarks for CO2 laser surgery.
  
  
  METHODS
  Forty-nine preoperatively untreated patients diagnosed as clinical T1-2N0M0 epiglottic carcinomas enrolled from June 1, 2006, to November 1, 2009 in the Second Affiliated Hospital of Harbin Medical University were studied retrospectively. Seventeen cases were treated by CO2 laser whereas 32 by open surgeries. The upper edge of thyroid cartilage and mucosal recess infra epiglottic tubercle could be used as intraoperation landmarks for transoral CO2 laser surgery. Optional neck dissections (II, III) were performed for 34 patients with tumors on laryngeal face, but not for 15 with tumors on the edges of epiglottis or small laryngeal face tumors.
  
  
  RESULTS
  The follow-up for this study covers a period ranging from 3 to 6 years postoperatively. Four local recurrences were found for this study, 2 for laser surgery who underwent additional repeated exisions and 2 for conventional techniques, one received radiotherapy (60 Gy) and another with total laryngectomy. The incidence of lymph node metastasis was 10.2% (5/49) in all cases. Time of naso-feeding or hospitalisation was significantly shorter for CO2 laser treated patients than that for open techniques. Overall 3 year's survival rates were 100% and 90.6% for CO2 laser and the open techniques respectively.
  
  
  CONCLUSIONS
  Compared to the open technique, transoral CO2 laser epiglottectomy is a well-tolerated and promising resection technique with low morbidity for early epiglottic carcinomas, and the identification of landmarks is useful for entire resection of epiglottis.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Harbin Medical University, Haerbin 150081, China (Email:liuming001@hotmail.com).
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.forename: Lin-li
authors.initials: LL
authors.lastname: Tian
authors.forename: Ya-nan
authors.initials: YN
authors.lastname: Sun
authors.forename: Jia-rui
authors.initials: JR
authors.lastname: Zhang
authors.forename: Hui
authors.initials: H
authors.lastname: Xiao
authors.forename: Jian-guang
authors.initials: JG
authors.lastname: Lu
mesh_terms: D000368:Aged; D002245:Carbon Dioxide; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004825:Epiglottis / Q000601:surgery*; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods; D007830:Larynx; D053685:Laser Therapy; D054020:Lasers, Gas / Q000627:therapeutic use*; D008207:Lymphatic Metastasis; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck
chemical_list: D002245:Carbon Dioxide